Combination therapy with beta-adrenoceptor blockers and calcium antagonists

Verapamil and nifedipine enhance the hypotensive and anti-anginal effects of beta-adrenoceptor blocking drugs. The combination of beta-adrenoceptor blocking drugs with nifedipine may pose fewer safety problems than the combination with verapamil especially in ischaemic heart disease when left ventricular function is suspect. Verapamil as a single agent may be as effective as a beta-adrenoceptor blocking drug in angina and provide a suitable alternative. Careful supervision is required when verapamil is combined with beta-adrenoceptor blockers for both angina and hypertension but reported clinical problems in hypertension are few.